Viral Respiratory Tract Infection During the First Postoperative Year Is a Risk Factor for Chronic Rejection After Lung Transplantation
Background. Chronic lung allograft dysfunction (CLAD) is the major limiting factor for long-term survival in lung transplant recipients. Viral respiratory tract infection (VRTI) has been previously associated with CLAD development. The main purpose of this study was to evaluate the long-term effects...
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2018-08-01
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Series: | Transplantation Direct |
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doaj-d39c3cf5d75b457591df25c2d53572512020-11-24T23:28:36ZengWolters KluwerTransplantation Direct2373-87312018-08-0148e37010.1097/TXD.0000000000000808201808000-0005Viral Respiratory Tract Infection During the First Postoperative Year Is a Risk Factor for Chronic Rejection After Lung TransplantationJesper Magnusson, MD0Johan Westin1Lars-Magnus Andersson2Magnus Lindh3Robin Brittain-Long4Rickard Nordén5Gerdt C. Riise61 Department of Internal Medicine/Respiratory Medicine and Allergology, Institute of Medicine, University of Gothenburg, Sweden.2 Department of Infectious Diseases/Clinical Virology, Institute of Biomedicine, University of Gothenburg, Sweden.2 Department of Infectious Diseases/Clinical Virology, Institute of Biomedicine, University of Gothenburg, Sweden.2 Department of Infectious Diseases/Clinical Virology, Institute of Biomedicine, University of Gothenburg, Sweden.3 Department of Infectious Diseases, Aberdeen Royal Infirmary, Aberdeen, Scotland.2 Department of Infectious Diseases/Clinical Virology, Institute of Biomedicine, University of Gothenburg, Sweden.1 Department of Internal Medicine/Respiratory Medicine and Allergology, Institute of Medicine, University of Gothenburg, Sweden.Background. Chronic lung allograft dysfunction (CLAD) is the major limiting factor for long-term survival in lung transplant recipients. Viral respiratory tract infection (VRTI) has been previously associated with CLAD development. The main purpose of this study was to evaluate the long-term effects of VRTI during the first year after lung transplantation in relation to CLAD development. Method. Ninety-eight patients undergoing lung transplantation were prospectively enrolled between 2009 and 2012. They were monitored for infections with predefined intervals and on extra visits during the first year, the total follow-up period ranged between 5 and 8 years. Nasopharyngeal swab and bronchoalveolar lavage samples were analyzed using a multiplex polymerase chain reaction panel for respiratory pathogens. Data regarding clinical characteristics and infectious events were recorded. Results. Viral respiratory tract infection during the first year was identified as a risk factor for long-term CLAD development (P = 0.041, hazard ratio 1.94 [1.03-3.66]) in a time-dependent multivariate Cox regression analysis. We also found that coronavirus in particular was associated with increased risk for CLAD development. Other identified risk factors were acute rejection and cyclosporine treatment. Conclusions. This study suggests that VRTI during the first year after lung transplantation is associated with long-term CLAD development and that coronavirus infections in particular might be a risk factor.http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000000808 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Jesper Magnusson, MD Johan Westin Lars-Magnus Andersson Magnus Lindh Robin Brittain-Long Rickard Nordén Gerdt C. Riise |
spellingShingle |
Jesper Magnusson, MD Johan Westin Lars-Magnus Andersson Magnus Lindh Robin Brittain-Long Rickard Nordén Gerdt C. Riise Viral Respiratory Tract Infection During the First Postoperative Year Is a Risk Factor for Chronic Rejection After Lung Transplantation Transplantation Direct |
author_facet |
Jesper Magnusson, MD Johan Westin Lars-Magnus Andersson Magnus Lindh Robin Brittain-Long Rickard Nordén Gerdt C. Riise |
author_sort |
Jesper Magnusson, MD |
title |
Viral Respiratory Tract Infection During the First Postoperative Year Is a Risk Factor for Chronic Rejection After Lung Transplantation |
title_short |
Viral Respiratory Tract Infection During the First Postoperative Year Is a Risk Factor for Chronic Rejection After Lung Transplantation |
title_full |
Viral Respiratory Tract Infection During the First Postoperative Year Is a Risk Factor for Chronic Rejection After Lung Transplantation |
title_fullStr |
Viral Respiratory Tract Infection During the First Postoperative Year Is a Risk Factor for Chronic Rejection After Lung Transplantation |
title_full_unstemmed |
Viral Respiratory Tract Infection During the First Postoperative Year Is a Risk Factor for Chronic Rejection After Lung Transplantation |
title_sort |
viral respiratory tract infection during the first postoperative year is a risk factor for chronic rejection after lung transplantation |
publisher |
Wolters Kluwer |
series |
Transplantation Direct |
issn |
2373-8731 |
publishDate |
2018-08-01 |
description |
Background. Chronic lung allograft dysfunction (CLAD) is the major limiting factor for long-term survival in lung transplant recipients. Viral respiratory tract infection (VRTI) has been previously associated with CLAD development. The main purpose of this study was to evaluate the long-term effects of VRTI during the first year after lung transplantation in relation to CLAD development.
Method. Ninety-eight patients undergoing lung transplantation were prospectively enrolled between 2009 and 2012. They were monitored for infections with predefined intervals and on extra visits during the first year, the total follow-up period ranged between 5 and 8 years. Nasopharyngeal swab and bronchoalveolar lavage samples were analyzed using a multiplex polymerase chain reaction panel for respiratory pathogens. Data regarding clinical characteristics and infectious events were recorded.
Results. Viral respiratory tract infection during the first year was identified as a risk factor for long-term CLAD development (P = 0.041, hazard ratio 1.94 [1.03-3.66]) in a time-dependent multivariate Cox regression analysis. We also found that coronavirus in particular was associated with increased risk for CLAD development. Other identified risk factors were acute rejection and cyclosporine treatment.
Conclusions. This study suggests that VRTI during the first year after lung transplantation is associated with long-term CLAD development and that coronavirus infections in particular might be a risk factor. |
url |
http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000000808 |
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